Inflammatory Bowel Disease Center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan,
Surg Today. 2014 Jan;44(1):39-43. doi: 10.1007/s00595-013-0563-z. Epub 2013 Apr 4.
Since 2000, the incidence of ulcerative colitis (UC) in patients over 60 years old has been rapidly increasing. We reviewed our surgical experience of elderly patients with UC treated at our hospital.
Patients aged 60 years or older at the time of surgery were defined as "elderly". The medical records of all elderly patients who underwent surgery for UC during a 26-year period were retrospectively analyzed.
The prognosis of elderly patients who underwent emergency surgery was extremely poor: 8 (26.7 %) of 30 such patients died within 30 postoperative days (PODs), whereas only 1 (0.88 %) of 114 who underwent elective surgery died within 30 PODs. Respiratory tract infection and sepsis resulting from methicillin-resistant Staphylococcus aureus or mycotic infection were the most common causes of death after emergency surgery.
The prognosis of elderly UC patients undergoing emergency surgery is very poor; thus, physicians and surgeons should collaborate to treat severe and fulminant disease, to optimize the timing of surgery. Early decisions about emergency surgery for UC will reduce postoperative mortality, especially in elderly patients.
自 2000 年以来，60 岁以上溃疡性结肠炎（UC）患者的发病率迅速上升。我们回顾了我院老年 UC 患者的手术经验。
手术时年龄≥60 岁的患者定义为“老年”。回顾性分析了 26 年间因 UC 接受手术的所有老年患者的病历。
行急症手术的老年患者预后极差：30 例急症手术患者中有 8 例（26.7%）在术后 30 天内死亡，而 114 例行择期手术的患者中仅 1 例（0.88%）在术后 30 天内死亡。急症手术后，导致死亡的最常见原因是耐甲氧西林金黄色葡萄球菌或真菌引起的呼吸道感染和败血症。
行急症手术的老年 UC 患者预后极差；因此，内科医生和外科医生应共同治疗重症和暴发性疾病，优化手术时机。对于 UC，尽早决定急症手术可降低术后死亡率，特别是对老年患者。
